The Prevalence and Etiologies of Transverse Myelitis in Latin America: A Systematic Review (P4-8.011)

Abstract

<h3>Objective:</h3> To investigate the prevalence of transverse myelitis (TM) in Latin America (LA) and identify common etiologies and preferred diagnostic tools. <h3>Background:</h3> TM is a rare neuroinflammatory condition of the spinal cord that can cause chronic and debilitating symptoms. TM is understudied in developing regions of the world, including in LA, leading to inequities in access to care. There is a need to investigate the disease’s prevalence in LA. <h3>Design/Methods:</h3> We searched PubMed and Cochrane Library for articles published in English, Spanish or Portuguese from 2010 to 2022 related to TM in LA. After excluding articles that did not meet eligibility criteria, we extracted data on population characteristics, TM frequency, etiologies, and diagnostics from each included article for descriptive analysis. <h3>Results:</h3> No studies were found that examined TM prevalence in LA or within a specific LA country. A total of 42 studies were included that investigated TM among LA populations with various primary diseases and 1 study on TM among a community population. A wide range of TM frequency data was found spanning 20 different LA countries. Demyelinating disease was the most commonly investigated TM etiology <i>(n=25 studies)</i> with the highest prevalence rates of TM. Infectious <i>(n=15)</i>, idiopathic <i>(n=3)</i>, vascular <i>(n=1)</i>, and post-vaccinal <i>(n=1)</i> etiologies were also examined in included studies. The most frequently utilized diagnostic tools for identifying TM were MRI, CSF cytology and CSF or serum antibodies specific to demyelinating or infectious diseases. <h3>Conclusions:</h3> This review highlights important gaps in identifying TM among general community populations and diseased subpopulations of non-demyelinating etiologies in LA. There may also be diagnostic access barriers to identifying TM outside of tertiary referral centers and specialized outpatient clinics. By improving our understanding of TM epidemiology in LA and diagnostic barriers, we may improve disability and health outcomes for patients with TM in LA. <b>Disclosure:</b> Mr. Almubaslat has nothing to disclose. Mr. Underwood has nothing to disclose. Ms. Torian has nothing to disclose. Miss Salvatierra has nothing to disclose. Miss Aponte Castro has nothing to disclose. Ms. Baldwin-SoRelle has nothing to disclose. Ms. Carlson has received personal compensation in the range of $500-$4,999 for serving as a Independent Consultant with Academy of Orthopaedic Physical Therapy, APTA, Inc.. Dr. Diaz has nothing to disclose.